H. Jack Geiger

Health care reform and primary care--the growing importance of the community health center.

The Patient Protection and Affordable Care Act enables community health centers to serve nearly 20 million new patients while adding an estimated 15,000 providers to their staffs by 2015. Dr. Eli Adashi and colleagues describe the “new” community health centers.

The Physician's Role in the Postattack Period

MANY monographs and articles1 2 3 4 5 6 7 8 have been written to acquaint physicians with the medical problems that might follow a thermonuclear attack on this nation. Often, these articles rely on...

The medical consequences of thermonuclear war: still relevant a half-century later?

On 31 May 1962 – 50 years ago – a fledgling Boston organization, Physicians for Social Responsibility, powerfully influenced American understanding of apocalyptic risks with the peer-reviewed journal publication in The New England Journal of Medicine of five articles collectively titled ‘The medical consequences of thermonuclear war’ (Aronow 1962, Ervin et al. 1962, Leiderman and Mendelson 1962, Nathan et al. 1962, Sidel et al. 1962). Those articles constituted the first comprehensive analysis by physicians and medical scientists of a clearly defined and specified thermonuclear attack on the US, including its human and ecological consequences in a given area (metropolitan Boston and southern New England). That publication had an enormous impact, nationally and internationally, on multiple audiences: frightened populations (worried about survivability in a thermonuclear conflict), physicians and other health providers, civil defence and military planners (the US military alone ordered a thousand reprints), strategic policy-makers, and mass media, both domestic and international. We review its findings now, half a century later, in order to consider some crucially important current questions. Do the old risks still have relevance today, in a substantially altered thermonuclear era? Do these old threats still persist, and are there new and different ones? Is there still a central role for physicians to play in prevention and public education? The studies in 1962 were based on a hypothetical 1445-megaton attack on US missile bases and cities that had been defined by the Joint Congressional Committee as a ‘realistic possibility’. In the Boston area alone, our analysis estimated, the blast, heat, and radiation from the attack’s thermonuclear weapons – each one now approximately a thousand times more powerful than the bombs dropped on Hiroshima and Nagasaki in 1945 – would kill 1,400,000